Evaluation of efficacy of school-based anthelmintic treatments against anaemia in children in the United Republic of Tanzania

Guyatt, H.L., Brooker, S., Kihamia, C.M., Hall, A. and Bundy, D.A.P. 2001. Evaluation of efficacy of school-based anthelmintic treatments against anaemia in children in the United Republic of Tanzania. Bulletin of the World Health Organization. 79 (8), pp. 695-703.

Title

Evaluation of efficacy of school-based anthelmintic treatments against anaemia in children in the United Republic of Tanzania

Authors

Guyatt, H.L., Brooker, S., Kihamia, C.M., Hall, A. and Bundy, D.A.P.

Abstract

Objective: To determine the impact of deworming on anaemia as part of a large-scale school-based anthelmintic treatment programme in the Tanga Region of the United Republic of Tanzania.

Methods: Both the reduction in the prevalence of anaemia and the cost per case prevented were taken into

consideration. Cross-sectional studies involved parasitological examination and anaemia evaluation before and at 10 months and 15 months after schoolchildren were dewormed.

Findings: Baseline studies indicated that the prevalence of anaemia (haemoglobin < 110 g/l) was high (54%)

among schoolchildren, particularly those with high intensities of hookworm and schistosomiasis. Attributable

fraction analysis suggested that hookworm and schistosomiasis were responsible for 6% and 15% of anaemia

cases, respectively. Fifteen months after deworming with albendazole and praziquantel the prevalence of anaemia

was reduced by a quarter and that of moderate-to-severe anaemia (haemoglobin <90 g/l) was reduced by nearly a

half. The delivery of these anthelmintics through the school system was achieved at the relatively low cost of US$ 1 per treated child. The cost per anaemia case prevented by deworming schoolchildren was in the range US$ 6 - 8, depending on the haemoglobin threshold used.

Conclusions: The results suggested that deworming programmes should be included in public health strategies for the control of anaemia in schoolchildren where there are high prevalences of hookworm and schistosomiasis.